Orofacial myofunctional disorders (OMDs) are abnormal movement patterns and resting postures of the face and mouth that interfere with normal growth, development, and function of the orofacial structures including the teeth. Children, teenagers, and adults may suffer from OMDs and can also have problems with talking, swallowing, and nasal breathing. A common OMD, or tongue thrust, occurs when a child or adult pushes the tongue out while talking, chewing, or drinking.
Signs and Symptoms
- Habitual open mouth, lips apart resting posture
- Abnormal tongue resting posture: low in the mandible, against, or in between the lateral or anterior teeth which impacts the normal resting occlusal relationship or ‘freeway space’ resulting in aberrant tooth eruption patterns/malocclusion.
- Non-nutritive sucking habits: finger, thumb, pacifier, bottle, breast past the age of 24 months.
- Abnormal functional swallowing pattern involving anterior or lateral interdental or linguadental tongue placement during the swallow and lack of a consistent linguapalatal seal.
- Abnormal functional patterns during chewing, bolus formation, and propulsion.
- Abnormal functional breathing patterns: apparent/obligatory mouth breathing.
- Abnormal speech patterns: interdental lisping, (distorted s,z sounds) unclear conversational Speech.
American Speech-Language-Hearing Association. (n.d.). Orofacial Myofunctional Disorders. (Practice Portal).
No single cause of orofacial myofunctional disorders has been identified, and its causes appear to be multifactorial. Anything that interferes with the tongue’s ability to rest and function within the oral cavity can contribute to an OMD.
The following are factors that have been identified as contributing to OMDs:
- Upper airway obstruction, due to obstructed nasal passages, or other structural abnormalities such as enlarged tonsils, adenoids, hypertrophied turbinates, and/or allergies, that interfere with effortless inhalation and exhalation. These may result in a chronic open mouth posture, as well as an incorrect swallow pattern and impaired nasal breathing.
- Chronic nonnutritive sucking & chewing habits past the age of 3 years of age (Sousa, et al., 2014; Poyak, 2006; Zardetto, et al., 2002)
- Orofacial muscular/structural differences that encourage tongue fronting could include: delayed neuromotor development, premature loss of maxillary incisors, orofacial anomalies, and ankyloglossia (tongue tie)
Oral myofunctional therapy (OMT) involves an individualized program of exercises and activities to retrain oral motor patterns that influence dental occlusion, facial shape, chewing, swallowing and speech patterns. Evidence has shown that OMT helps in the retention of dental/orthodontic treatment as well as creating and maintaining a healthy, optimum orofacial environment.
- Establish and habituate normal freeway space dimension by eliminating parafunctional sucking habits and inappropriate tongue, lip, and jaw postures
- Establish and habituate a closed lips, nasal breathing oral resting posture
- Establish and habituate a mature swallow pattern utilizing a consistent linguapalatal seal
- Establish and habituate mature chewing patterns
- Establish and habituate normal articulation patterns
CCSPOM’S OMT program involves a weekly 30 minute visit for approximately 12-16 visits. The first third of the program involves strengthening and patterning work, the middle third involves training actual skills, and the final third focuses on habituating or unconscious competence with newly learned patterns. Follow up visits are scheduled 4 times over the course of a year following completion of the program.
An interdisciplinary team of professionals may be involved in treatment including:
Certified Orofacial Myologist
Sleep Disorder Specialist
Only therapists certified by the International Association of Orofacial Myology have the appropriate education and training to provide treatment. The IAOM, a professional organization founded in 1972, is the ONLY international professional accrediting organization for this specialty. IAOM members who have earned the credential COM have the appropriate training to identify orofacial myofunctional disorders and provide orofacial myofunctional treatment.
Patricia is an IAOM COM ® and licensed speech pathologist. She is the only COM ® on the CentralCoast of California between Santa Barbara and San Jose. Past President of the IAOM from 1997-2002and member of the IAOM Board of Examiners between 1987-2021, Patricia has extensive training and experience with orofacial myofunctional disorders and speech sound disorders and is considered an expert in these fields.